Initial Consult went bad

I went and waited in the waiting room for 1 1/2 hours and then talked to the financial lady and she said Tricare will cover everything but $2002.00! Enrollment fee $500.00 Psychological Eval $400.00 Blood Draw $42.00 Spirometer $60.00 All Inclusive 3 year Support Program (remaining balance) $1000.00 Is this right??? I am so disapointed. I dont have $2002.00.

(((HUGS)))) Yeah, Tricare wouldn't cover my program fees ($750) either. But they have covered all my labs and my psych. eval. I didn't need a spirometer, I'd call Tricare and see about that one. As long as you have your psych eval with an in-network doctor, it will be covered. You don't need a referal for the first visit (Tricare treats behavior health consults different then other consults), but if you are required to have additional visits, your psych doc will have to put in a referal for you to see them those additional times. The labs/bloodwork; mine is done in the hospital my program is located in. This is a Tricare excepted facility, so maybe that makes a difference? But I don't see why yours wouldn't be covered either. If all else fails take a bloodwork order to your PCP and have him send a copy to your surgeon. That way it will be paid. I'd call Tricare and see what they say. Even if you just found out, by Tricare, which procedure codes your surgeon would need to submit to Tricare, it could save you some money. HTH Andi

whoa. what kind of tricare do you have? that probably makes a difference. do you know if you two are moving to camp pen yet? if so, i know balboa can do the surgery for you, but i believe they have a whole program to do before the surgery? balboa is in san diego. tricare prime will pay for everything as long as it is at a military hospital. adrienne ps you might want to talk to navy marine corps relief. they might be able to help you out with your medical bills. you will still have to pay for it, but they might be able to give you a loan to cover the medical expenses at 0% interest.

I do have Tricare Prime. That is why I was surprised and disapointed. So I am going to get on the phone with Balboa tomorrow to see if they do lap bands (I am hoping since Walter Reed does too) We are probably going to go to Camp Pendleton, I just dont know when.

That's.....crazy! Is it a civilian surgeon that you had gone to then? Something doesn't sound right. I'd be on the phone with Tricare to see what the heck was going on. I wonder if the girl in finance had gotten your tricare programs confused?

This is indeed a civilian doctor. Yeah we plan on making lots of phone calls tomorrow. Everything is closed right now. Now if Balboa will do Lap Bands, I will most likely wait til I get to Camp Pendleton. If not, I am going to get on the phone with Tricare about the $2002.00 out of pocket fee. I think this is crazy too!

I am sorry to hear about that. The program fees are entirely up to the doctor. When I first tried to have the surgery in SC (before my husband got his orders). They had a 500 dollar program fee. I remember a man at the seminar asked what on earth was the program fee for. The head nurse said that it covered the nutritionist there and some other small thing; but mostly it was so people wouldn't back out at the last minute before surgery if they had their own money invested in it. They charged 250 dollars upfront and 250 when all your paper work went through. I thought that was bad until a lady in the group said that that was good because a popular WLS Dr. in Charleston SC charged 2000 dollars program fee. The doctor I am seeing now doesn't have a program fee.. it just depends on your doctor. I think it is unfair...I guess it is like that nurse said it mainly to make sure the people that are seeking the surgery don't back out at the last minute with their money involved. Still SUCKS LOL!!!!

Hmmmm then I think I will wait for a military doc to do my surgery! Screw that program fee bull****! Thanks for telling me about that...I had no idea!

lol

Do you have Tricare Prime? I do and the only thing I have had to pay for is the nutrition consult and that was $50. Tricare covered everything else. I have a psych eval September 17th and have not heard anything about having to pay for that either.